Carrier News

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

BrushSmart: Delta Dental’s At-Home Oral Wellness Program

Posted May 15, 2023 by Lori Berson

Delta Dental is offering BrushSmart to its PPO™ and DeltaCare® USA members, providing significant discounts on dental products from major brands to encourage better at-home oral care habits.

BrushSmart Member Benefits Include:

Savings on smart toothbrushes, electric toothbrushes, and other dental health products.
Discounts include 25% off and free shipping from quip, savings on purchases of $100+ from Oral-B, and 20% off and free shipping from Philips Sonicare.

The program aims to enhance at-home oral care and complement routine dental check-ups. All Delta Dental PPO™ and DeltaCare® USA members across all lines of business are eligible to enroll in BrushSmart. Members simply sign up for BrushSmart to have discounts sent directly to their inbox. Get the details.

Contact us today for a Delta Dental quote.

Resources

Elevate Your Smile flyer.
Get to Know The Delta Dental PPO and Delta Dental Premier Networks video.
Delta Dental Small Business Program brochure.
Delta Dental’s SBP plan comparison.

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

MetLife Webinar: The Advantages of Employee Care

Posted May 15, 2023 by Lori Berson

Attend the MetLife webinar on Wednesday, May 17th at 10:00 am PT, with Vincent Branchesi, MetLife workforce expert and a leading voice of MetLife’s 21st Annual U.S. Employee Benefit Trends study, as he shares their latest research and recommendations.

You’ll learn:

The latest trends in workforce dynamics.
New approaches for talent management and benefits.
How to support your ever-evolving workforce.

Register Now!

Contact us today for a MetLife Quote!

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Covered California for Small Business – All-New Blue Shield Plans

Posted May 1, 2023 by Lori Berson

With the newly added Blue Shield plans, Covered California for Small Business (CCSB) provides even more options for enrollees.

Effective July 1 these plans are new:

Access+ HMO Network: Blue Shield’s full HMO network, is now available in Platinum, Gold, and Silver metal tier plans. These plans had been available only with the Trio HMO network. Access+ plans include the richer Rx Ultra pharmacy network.
Bronze Trio HMO 7000/70. Professional services are not subject to a deductible. Includes integrated pharmacy deductible and access to Concierge Member Services.
HSA Plans: two of Blue Shield’s most popular HDHP plans: Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans. Both plans feature the Full PPO network. In both plans, the deductible and out-of-pocket maximum are the same. No additional cost to the member after the deductible is met.

All Blue Shield plans through CCSB provide members access to Wellvolution (including Headspace and Ginger), Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.

New Broker Bonus Program

With the new CCSB ‘A Partnership That Pays’ bonus, agents who place new small group business with CCSB from July 1, 2023 – January 1, 2024, can earn up to a $12,000 bonus per group, in addition to competitive commissions. To qualify for the first bonus tier of $1,000, agencies must submit a minimum of three groups with four enrolled employees. Best of all, the bonus is per group with no maximum number of groups! Download the flyer for details.

In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:

Full-network PPO from Blue Shield.
HMO offerings from Blue Shield, Kaiser Permanente, and Sharp Health Plan.
New Blue Shield plans.
4-tier selection.
Single bill.

Partner with Claremont for:

Help understanding employers’ needs to deliver the right benefits solutions.
Assistance with small group sales, enrollments, and renewals.
Actionable solutions and practical tips, such as:
– Advantages for Agents and Employers
– Agent Resources
– Health Care Tax Credit Solution
– Top 20 Lowest Cost Medical Plans
Expertise and support behind the scenes — all at no cost to you.

As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.

To take advantage of the Broker Bonus Program, contact us today for a Covered California for Small Business quote!

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Schedule a 15-Minute Briefing

In The News: Unwinding of Medi-Cal Continuous Coverage

Posted May 1, 2023 by Lori Berson

Check out these articles to learn more about the unwinding of Medi-Cal continuous coverage:

Millions on Medicaid May Soon Lose Coverage as Pandemic Protections Expire (The New York Times)
Medicaid Eligibility Changes Set to Hit Hospitals, Insurers, States (Wall Street Journal)
‘A perfect storm’: Patients trying to hang on to Medi-Cal face long waits for help. (Los Angeles Times)

For many of the millions of Californians expected to lose Medi-Cal coverage, enrolling in their company health plan may be the best or only option for affordable coverage.

Your employer clients and prospects look to you for guidance and support in maintaining a healthy and productive workforce. This is a singular opportunity to deepen your client relationships, acquire more customers, and grow your business.

Schedule a 15-minute briefing with Claremont to learn more about how your clients will be impacted, the opportunity for you, and how Claremont will help.

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Beam – Critical Illness Coverage

Posted May 1, 2023 by Lori Berson

Help employers provide extra protection and financial security for their workforce in the event of a serious illness or injury by offering Beam’s new critical illness coverage.

The coverage includes a range of benefits, such as hospital stays, surgery, chemotherapy, and radiation treatments. Plus, it also offers financial assistance for expenses related to caregiving, travel, and other non-medical expenses.

A great option to supplement traditional health insurance, Beam’s critical illness coverage can be especially helpful for those with high-deductible health plans (HDHP).

Features Include:

Four standard plan options.
Lump-sum cash payment goes directly to the member.
Members have the flexibility to use the funds as needed.
Provides coverage for a broad list of illnesses and diseases.
Coverage is available for members, their spouses, and their dependent children.
No lifetime maximum benefit amount.
Recurrence benefit included.
Voluntary, contributory or non-contributory.

A valuable addition to standard health insurance, Beam’s critical illness coverage can provide employees peace of mind and financial assistance during challenging times. Download the flyer for details.

Contact us today for a Beam quote.

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

RxDC Reporting Deadlines

Posted April 27, 2023 by Lori Berson

Article last updated: April 27, 2023.

Most of your clients likely have upcoming deadlines under federal prescription drug benefits reporting requirements. Here’s a summary of the requirements, how carriers can help, and the deadlines.

Summary of The Prescription Drug Benefits Reporting Requirements

Under Section 204 of the 2021 Consolidated Appropriations Act (CAA), insurance companies and employer-based health plans must submit information regarding prescription drug benefits and health care spending. The information must be submitted to the Centers for Medicare and Medicaid Services (CMS) by June 1st of each year for the prior year’s coverage.

Enforcement of the requirements was relaxed for reports due in 2021 and 2022. The requirements for reports due in 2023 are being enforced. Failure to report can lead to a penalty of $100 per day per affected individual.

A detailed summary on the requirements can be found in this helpful Mercer article (many carrier communications that you and your clients are receiving refer to technical terms such as “P2,” “D2-D8,” etc. This article explains these terms).

Carrier Actions and Deadlines

Each carrier is taking action to support your employer clients with the federal reporting requirements. In order to do so, they require information from each employer group. The approach being taken by each carrier is similar, but varies in detail, including important deadlines. Here’s a summary:

Aetna
Plan sponsors should fill out this RxDC Plan Sponsor Data Collection form with the required data by April 1, 2023. The required data includes the:

Average monthly premium paid by members.
Average monthly premium paid by employer.
Funding arrangement.
Issuer name/legal entity.

Anthem
Anthem is sending emails to Small Group and Large Group fully insured clients and Anthem Balanced Funding clients, asking them to submit monthly average premium information required for Prescription Drug Data (RxDC) reporting. Anthem clients should complete this form before March 24, 2023.

Blue Shield of California
Blue Shield is providing fully-insured groups and self-funded ASO group plan clients an option for collecting and reporting all the required information on their behalf. Groups electing this option must complete a Blue Shield Intake Form. Blue Shield has provided an Intake Form FAQ.

Blue Shield will submit the data report on behalf of fully-insured and self-funded ASO group plans only if the group provides a complete response to the questions on the intake form by March 31, 2023 by 6:00 pm PST. By completing the form, the employer consents that Blue Shield will submit the data on their behalf to the CMS.

If the employer group does not complete the intake form by March 17, 2023, then the employer group will be responsible for submitting all required data directly to the CMS by June 1, 2023.

More details can be found in emails sent recently by Blue Shield directly to brokers and employer groups.

CaliforniaChoice

Anthem enrollment – Anthem will work with CalChoice to gather the information needed and will file required reports on behalf of the employer.
Kaiser enrollment – no action is required by the employer.
Sutter enrollment – no action is required by the employer.
UnitedHealthcare enrollment – employers who missed the March 10 deadline are required to file D1 and P2 themselves by the June 1 deadline. They refer employers to these CMS Reporting Instructions.

The information above from CaliforniaChoice was provided verbally. Until this information is formally posted on the CaliforniaChoice website and especially for employers with Kaiser and Sutter enrollment, who are being advised that no action is required, Claremont strongly recommends that brokers contact the carrier and get formal confirmation as to what reporting assistance the carrier will or will not provide. In all cases, it is strongly recommended that the broker or employer request a receipt that the necessary reporting was indeed filed by the carrier. Keep that receipt in the event of a CMS audit.

Cigna+Oscar
Cigna intends to file on behalf of plan sponsors. No action is required of brokers or employers at this time. Look out for future communications from Cigna and Cigna + Oscar.

Covered California for Small Business
Covered California for Small Business (CCSB) is an administrator of its participating health plans and is not subject to RxDC data collection requirements on behalf of employer groups. CCSB has provided the following information for each of their participating health plans:

Blue Shield of California issued a Broker Alert detailing instructions for the submission of group data via an intake form. The deadline for the submission of this form was March 31st. Employer groups who missed the deadline are now responsible for submitting their data directly to CMS by June 1, 2023.
Kaiser Permanente is compiling and submitting the required data on behalf of their employer groups.
Sharp Health Plan will be contacting their employer groups directly to obtain the required information. In addition, they will be sending a broker and employer alert informing all brokers and CCSB employers of the RxDC reporting requirement.

More details can be found in this April 11, 2023 CCSB broker email.

Kaiser Permanente
Kaiser Permanente (KP) needs to collect certain data in order to submit all applicable reports and required responses on behalf of employers. Employers with KP coverage in 2022 should complete this form no later than April 3, 2023. The broker can also complete the form on behalf of the employer. Once KP has the necessary data, it will submit all applicable reports and required responses to the CMS by the June 1, 2023 deadline.

Note: Kaiser asks for the data in a different way than other carriers. To help simplify the process, Claremont has created a worksheet (Excel, PDF) with instructions. If the broker or employer can assemble three pieces of data for each month in 2022, they can enter those into the worksheet and it will calculate the answers for Questions 8 and 9 which can then be entered into the Kaiser form.

Sharp Health Plan
Sharp Health Plan will be contacting their employer groups directly to obtain the required information. In addition, they will be sending a broker and employer alert informing all brokers and employers of the RxDC reporting requirement.

UnitedHealthcare
UnitedHealthcare (UHC) will assist clients by submitting all required information to the CMS if the employer completes UHC’s Pharmacy and Benefits and Costs Survey by March 10, 2023.

UHC sent an email communication on February 3, 2023 to all brokers/groups with fully-insured and Level-Funded plans instructing them of the data collection and action required to complete the Survey. Here is a link to the FAQs from UHC. It also links to the survey. Once the survey is complete, UHC will submit the necessary data to the CMS on behalf of the employer prior to the June 1, 2023 deadline.

Summary

The carriers are taking action to support your clients with the federal reporting requirements. In order to do so, they require information from each employer group. Look out for emails directly from the carriers, and follow their instructions. If you or your clients have questions, we can help direct you to the right contacts at the carriers.

Contact us today for assistance.

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Covered California for Small Business – Continued Growth, New Blue Shield Plans, and New Broker Bonus Program

Posted April 17, 2023 by Lori Berson

Continued Growth

With over 9,020 employers and 79,770 employees enrolled as of December 2022, Covered California for Small Business (CCSB) continues to be a popular health insurance choice for small businesses. In fact, membership has grown significantly over the last few years:

New Blue Shield Plans

CCSB is introducing the following new Blue Shield plans for Q3-2023 (effective July 1, 2023):

Access+ HMO Network: Blue Shield’s full HMO network, is now available in Platinum, Gold, and Silver metal tier plans. These plans previously only had access to the Trio HMO network. Plans offered on the Access+ HMO network will include the richer Rx Ultra pharmacy network.
Bronze Trio HMO 7000/70 is new to CCSB. Professional services are not subject to a deductible. Includes integrated pharmacy deductible and access to Concierge Member Services.
HSA Plans: two of Blue Shield’s most popular HDHP plans: Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans.

All Blue Shield plans through CCSB provide access to Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for members outside of California.

New Broker Bonus Program

With the new CCSB ‘A Partnership That Pays’ bonus, agents who place new small group business with CCSB from July 1, 2023 – January 1, 2024, can earn up to a $12,000 bonus per group, in addition to competitive commissions. To qualify for the first bonus tier of $1,000, agencies must submit a minimum of three groups with four enrolled employees. Best of all, the bonus is per group with no maximum number of groups! Download the flyer for details.

Broker Webinar Recap and Q&As

View the March 28th broker webinar and download the Q&As to learn about CCSB’s growth, advantages for brokers and employers, and the latest carrier offerings.

In addition to California’s most comprehensive access to doctors and hospitals, CCSB health plans offer choice and control, with:

Full-network PPO from Blue Shield.
HMO offerings from Blue Shield, Kaiser Permanente, and Sharp Health Plan.
New Blue Shield plans.
4-tier selection.
Single bill.

Partner with Claremont for:

Help understanding employers’ needs to deliver the right benefits solutions.
Assistance with small group sales, enrollments, and renewals.
Actionable solutions and practical tips, such as:
– Advantages for Agents and Employers
– Agent Resources
– Health Care Tax Credit Solution
– Top 20 Lowest Cost Medical Plans
Expertise and support behind the scenes — all at no cost to you.

As a trusted CCSB partner since its 2014 launch, we are a top-producing general agency in our sales territory. From agent certification and quoting to assessing new group eligibility and resolving post-enrollment issues, our CCSB experts will provide guidance and support every step of the way.

To take advantage of the broker bonus program, contact us today for a Covered California for Small Business quote!

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield – New Broker Rewards Programs, Q3-2023 Rates Now Available for Quoting

Posted April 17, 2023 by Lori Berson

Small Business Incentive Program

With Blue Shield’s Small Business Incentive Program, earning points for qualified sales has never been easier (February 1, 2023 to January 1, 2024 effective dates). You can redeem your points for rewards from hundreds of great options, such as gift cards, electronics, products for your home, and more. Or convert your points to cash with a Visa gift card. Best of all, there are no complicated tiers or calculations required!

You Can Earn

100 points per new member who enrolls in a Tandem PPO plan or a Virtual Blue plan as part of the initial sale.
50 points per new enrolled medical member on all plans, excluding Tandem and Virtual Blue PPO plans as part of the initial sale.
10 points per new enrolled member in a small business dental plan.
5 points per new enrolled member in a small business vision plan.
5 points per new enrolled member in a small business life insurance plan.
40 points (2x points) per new member enrolling in all three – dental, vision, and life.
25 points for setting up a group on autopay during initial enrollment.

With the Producer Rewards points-based bonus program, each point is equal to one dollar. Plus it’s easy to keep track of your point status and what you’ve earned.

Learn more about the Small Business Incentive Program and Producer Rewards Program. Enroll in the Blue Shield Producer Rewards Program today.

Groups written through Claremont are eligible for this program.

Renewal Rewards Program

As an additional incentive, earn points redeemable for rewards for renewing groups with new members into Blue Shield’s Tandem PPO, Virtual Blue, or specialty plans. What’s more, all point distributions are in addition to standard commissions.

How to Qualify

Applicable for small groups (1-100 employees).
Brokers must opt-in by submitting a W9 form. If a broker is part of an agency, the parent agency must opt in first.
Renewal submissions must be submitted through the Small Group Online Renewal Tool using the same broker profile as the one that opted in. New Blue Shield members enrolled at group renewal must be enrolled through Employer Connection.

You Can Earn

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Download the Renewal Rewards Program flyer to learn more.

Groups written through Claremont are eligible for this program.

Q3-2023 Rates

Rates are now available for quoting through PRISM, our free and easy online quoting system.
The Q3 rate action is a statewide average of 1.9%.

Contact us today for a Blue Shield quote and start earning rewards!

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Beam Two-Year Rate Guarantee

Posted April 17, 2023 by Lori Berson

Help give your clients financial protection and peace of mind with Beam’s two-year rate guarantee on new dental and vision quotes. This promotion is available to groups with 10-499 eligible employees who quote with Beam now through June 30, 2023, with an effective date between April 1, 2023 and September 1, 2023. To learn more, visit Beam and download the flyer.

Reminders

Beam dental and vision plans are available for 2+ enrolled employees.

Standard Plan Features

Annual open enrollment on all plans.
No waiting periods unless requested.
Preventive care is covered at 100% (2 annual cleanings and check-ups).
No missing tooth clause.
Implants are covered on all dental plans.
Posterior composites and porcelain crowns are covered with no downgrades.
Occlusal (night) guards are covered.
Rollover feature offered to match or add as new.
Additional cleanings for pregnant members.
Additional cleanings for members with diabetes.
Beam Perks program for group incentives and member rewards.

Dental Provider Networks

Beam has over 500,000 dental access points nationwide.
Access points are comprised of these dental networks: Dental Benefit Providers (DBP owned by UHC), Careington, DenteMax Plus, Connection Dental, and First Dental Health.
Find an in-network dentist.

Vision: VSP® Vision Care Plans & VSP® Choice Network

Frame allowances – $150, $175, $200.
Frequency limits – 12/12/12 and 12/12/24.
Available for 2+ enrolled employees.
Nationwide provider network and retail locations with over 115,000 vision access points and more than 31,000 providers.
Find a VSP Network eye doctor.

Start quoting Beam today and help your groups take advantage of the rate guarantee!

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.